Ow

I did some training/recertification on dealing with violent situations in the hospital and reinjured my knee that I sprained 2 winters ago skiing. Stupidly I heard it crack during 1 situation, then thought, oh well try again. Then ended up on the floor. Now I am icing it and thinking I will probably need to wear a knee splint thing tomorrow at work. Nurse, heal thyself.
We talked a lot about violence etc. Really, though people often think that in psychiatry that it is so unsafe, I hardly ever feel unsafe at work. Only if someone is being particularly difficult and that hardly ever happens. I think nurses are much more likely to get injured in long term care, with people who have dementia. Or ER, where people are coming in off the street-with who-knows-what going on.
When people go onto the psych unit, they tend to be surprised at how quiet it is. We obviously try to keep it low key for a reason, as loudness stresses people out, but I think how difficult it is for people on other units with machines beeping, call bells ringing, people rushing around. How does anyone sleep? It goes on all night. I remember when Dad was in ICU after his sugery and he got delerium and the nurses saying, oh he needs to get some sleep. Well, whenever was there, lights were on, it was loud, how does someone who is all drugged up, in pain and not in their own bed sleep through all of that?
There are many ways that in the hospital we make healing difficult for people and I think noise stress is not looked at enough. Along with about a 1000 other things.

Why do we do work?

Work went really well this week, even though we were soooo busy and short staffed. I'd much rather be busy and deal with some increased stress from that, rather than be less busy and be stressed from complaining nurses.
I was talking with a friend who also nurses and we were discussing why we like work. She talked about certain moments where you feel like you are witnessing something really amazing. Like when someone who has been so sick, takes a turn and begins to get better.
I had to work overtime for 2 hours as we were short 2 staff for the next shift. I hardly ever do it and it was my last shift, so I thought, sure why not? A family from out of town came to see a patient, and they looked so tired. I asked whether they had a place to stay, they didn't. So, I called a motel that I thought would be reasonable, clean, and close, and then drew them a little map of how to get there. They were really appreciative, though it maybe took 5 minutes to do. That is the kind of thing that keeps me feeling happy when I leave work. Naturally, the pay is good, benefits are good, and I live nice and close, so there is no commute, but honestly, it is the small things that give a sense of fullfillment. Like when patient brought me back a coffee (with cream and sugar-and I take it black), but I drank it and thought, how thoughtful is that? Someone is in the hospital and yet they gave this to me! Or a patient made me a piece of jewellery and wrote me a letter thanking me. Or holding a person's hand because they are scared. Or I see an old patient working and they remember me and we talk about how they are doing now, and I think 'they look great!'
We just got a contract extension and the gov't gave us a raise after this contract ends. Cost of living. To be honest, I think I make a lot of money already-this is not necessarily popular to say in the nursing station, and given the present economic climate, I thought we were lucky to get cost of living-again not popular. But this money wouldn't really mean anything if I didn't like my job and didn't feel happy while I was there. I don't always put in for missed breaks and stuff because I think that sometimes I can take a few more minutes on one, and I think that in the end, it all evens out. I do believe that it is OK for me to go the extra mile once in a while because it's a good job and I feel that I am appreciated at work. Happiness certainly is not contingent on the amount of money you make. I am not saying that I don't feel that I earn the money I make, because I believe that I do-it is sometimes a difficult job-but what keeps me happy there isn't the money, it is the actual work-with all its' difficult times.

Preceptor

So, the educator at work asked if I'd preceptor a nursing student for her practicum. I happily obliged. I met her for coffee yesterday and I think she will be good-seems very keen and bright and personable.
I like doing this kind of stuff though I think perhaps other seasoned nurses might think, who does she think she is? She just graduated 2 years ago and she's helping a 3rd year nursing student! But I feel that our educator wouldn't have asked me if she thought I'd not be good at it.
I hope that I do a good job. I'd really like honest feedback from this woman on how her learning experience is and what I could do to improve. Having a good preceptor can really break or make your practicum. Which leads me onto my ongoing thoughts of 'nurses eating their young', which is just another term for lateral violence. Why is it that nursing and nurses as caring professionals are often unsupportive towards their peers? I saw it as a student, where I was referred to as 'the student' and not by name, and was not always received with open arms when arriving on the floor. And working as a nurse, there have been many instances where I've seen it happen to others and towards me personally.
I think it would be an interesting research project. I've read some stuff that talks about nurses being traditionally undervalued, oppressed group and these groups will often turn in on themselves to deal with the stress and lack of power they feel. Like some immigrants to new places who form gangs to belong, but end up terrorizing other people. I've also read about healthcare being an incredibly hierarchical workplace where different levels of power are assigned depending upon your role-also leading to kicking the dog kind of behaviour. And always blamed is the stress, and high pressure work environment where as nurses we are responsible for people's lives. When doing research for a paper I wrote on nurses and addiction, some articles talked about nurses tending to be Type A personalities-perfectionist and not forgiving of mistakes-either our own or others, and there is also research reporting that nurses tend to internalize stress and their job-which would lead to higher stress and therefore presumably more irritability and taking stuff out on those around you. To be honest, I also think that a union environment adds to this-Mom, nevermind the comment you are about to make about I told you so. It can add to an us vs them atmosphere where it is someone else's fault that things aren't good-whether that's the actual management, health care system, government, patients, co-workers, the person who looked at us funny on the way to work. Blame is not helpful in dealing with healthcare-though it certainly seems to be what we do-as a society we blame the government for poor health care, as nurses we blame the doctor for poor medical decisions, the medical system blames the patients for their own poor health (if only people exercised, ate well, lowered their stress etc. they'd live longer and stop costing taxpayers money). Doctors blame nurses for under/overreporting concerns. Someone told me a Dr said she should go back to nursing school when this nurse called about a concern.
All this being said, I think it is our own responsibility to ensure that we create a safe, comfortable working place. And be aware enough of ourselves that we recognize when we are perpetuating this power imbalance-in whatever form it may be. I know that I have done this-questioning what others do and being snide about it. I do try to be positive and upbeat at work and to be supportive of others without being an unquestioning ninny, which can lead to, 'well, we've always doen it that way, why would we change it?' My big teeth-clenched, bite-my-tongue reaction honestly does happen when I feel that patient care and rights are not being respected. And if I feel that patients are not being treated with dignity and value. Not to say that I don't get annoyed when I have a personality conflict with another person-especially when dealing with someone who is in my view more rules oriented-I mean yes, rules are there for a reason, but shouldn't we consider the reason behind it? And I do like gossip. A lot. However, it is my professional responsibility to act as a professional-which means good, clear communication and thoughtfulness behind all my interactions at work.

Psych

As in it feels weird to write this weblog.

And I am thinking of writing about general nursing issues related to psychiatry.

So far, not very interesting, really. Or perhaps only interesting to me?

Though in school we talked a lot about the role of the nurse and how there is not very much accurate information about what nurses do, there is even less accurate information about what nurses in psychiatry do. Do we wander around jabbing people who act strange with needles, spending the rest of the time in the nursing station coldly plotting how to destroy people's lives per One Flew Over the Cuckoo's Nest? Do we dress all in white, peering in locked rooms at dangerous people, as in The Terminator? (where the mom is in the forensic psychiatric hospital) Do we inject people with insulin to get rid of hallucinations as in the most recent episode of House-which I might say had no clue about actual treatment of psychosis.

Sadly, even within the workplace as nurses we perpetuate these sterotypes and worse, we end up promoting stereotypes about people with mental health issues.

I've been doing research for our nursing practice committee related to psychiatric issues and I have to say that there is not enough research done on psychiatry and poor information out there for nursing practice within this area. It is frustrating when you think that (give or take depending on what research you use) 25% of the population will have a mental health issue at one time or another during their life.